VCP South, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

048566 Issued in GA

Legal business name

VCP SOUTH, LLC

Doing business as

Vein Care Pavilion of the South

Practice address

4350 Towne Centre Dr
Ste 2000
Evans, GA 30809-3301

Phone

(706) 854-3333

Fax

(706) 396-0615

NPI assigned

Jun 8, 2006

Last updated

May 23, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven M Roth, M.D.

Title

Sole Member/President

Phone

(706) 854-3333

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vein Care Pavilion of the South Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1811937402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR",
            "address_2": "STE 2000",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093301",
            "telephone_number": "706-854-3333",
            "fax_number": "706-396-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR",
            "address_2": "STE 2000",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093301",
            "telephone_number": "706-854-3333",
            "fax_number": "706-396-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VCP SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "706-854-3333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "048566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "985661",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vein Care Pavilion of the South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Vandeventer
• Vanitcha R Pintavorn (Augusta Family Allergy & Immunology)
• Carmen D. Vaughn, D.M.D.
• Teia D. Vaughn, RKT
• VCP Memphis, LLC (Vein Guys)
• VCP2 Augusta PC (Vein Guys Augusta PC)
• Lydia Veihman
• Wendy Lee Vello, LCSW, LISW-CP
• Ventura Medstaff LLC
• Christopher L Vickery, MD

• Vascular Surgery Physician in Evans, GA
• Providers in Evans, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.